Robotic management system for limb rehabilitation

ABSTRACT

A robotic management system to control an apparatus that comprises of a mobile-frame, dynamic weight unloading mechanism and lower extremity exoskeleton device is disclosed. The fall safe apparatus receives the input from the doctors, users and therapist and the robotic management system automatically calculates the exercise routine using the robotic management system. An intelligent algorithm, embedded onto a dedicated processor, actuates various motors to execute the prescribed exercises, while the sensors provide dynamic feedback for corrective measures to control the exercise routine.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a divisional application of and claims priority toU.S. application Ser. No. 16/204,836 filed on Nov. 29, 2018. The USapplication is now allowed. The disclosure is hereby incorporated bythis reference in its entirety for all of its teachings.

FIELD OF THE INVENTION

The present invention relates to a robotic management system for limbrehabilitation. More specifically robotic management system that helpsregain gait in a human being.

BACKGROUND OF THE INVENTION

There are over 10 million persons with locomotion disorders inworldwide, caused by various life changing incidents such as stroke,spinal cord injury, war injuries or other diseases. As a result of lossof the physical mobility, the affected person cannot carry out hisdesired or even day to day activities with full participation or inworse cases resulting in complete loss of mobility. Further the affectedpersons are prone to suffer from severe emotional trauma and depressionas a result of their condition.

Various assistive devices have been developed over last decade forassisting the persons suffering from the mobility disorders with anobjective to help the disabled person to regain the ability to stand andwalk, and also minimize the requirement of intensive therapist dependenttraining. One category of assistive devices that help in rehabilitationis exoskeleton in nature. A powered exoskeleton device is a wearablemobile machine that is powered by a system of electric motors orpneumatics or levers, or hydraulics, or a combination of technologiesthat allow for limb movement with increased strength and endurance.However, these devices have major drawbacks and are limiting their useas both therapeutic as well as a mobility device. The drawbacks includehigh dependency on the operating therapist, no automatic assessment foradjustment of the exercise routine and also consecutive change nprotocols based on pass history of the patients use and improvements.

In view of the foregoing, there is a need for a robotic exoskeletonassisted rehabilitation system that is 100% fall safe, which enablesearly intervention, even while walking with the exoskeleton device,light in weight and easy to use and move around and most importantlycost effective as compared to the systems that are presently available.

SUMMARY

The instant application discloses a robotic management system to be usedin a lower limb rehabilitation apparatus and system. The robotic limbrehabilitation apparatus is aided by a system with various modules tocontrol the apparatus. In another embodiment, the ankle joints may alsobe powered through the lower extremity exoskeleton device. In oneembodiment, the exoskeleton apparatus works not only in conjunction withthe mobile-frame, the harness for weight support and sensors formonitoring/adjusting/analyzing/feedback on the lower limb movements, butalso with robotic management system to control each part of theapparatus.

In one embodiment, a robotic management module and system is implementedusing a processor, device and hardware to optimize the exercise for auser and that controls the robotic lower limb rehabilitation apparatus.In another embodiment, a closed loop control system is implemented todeliver the prescribed therapy protocols to the patient. Multiplesensors are used to detect the patient gait behavior and effort that isattached to the lower extremity exoskeleton device and the mobile-framesensors, and based on the feedback received; a proprietary controlalgorithm sends the corrective actuation signals to the motors. A sensorbased input from the lower extremity exoskeleton device and the roboticlower limb rehabilitation apparatus is collected in the database andused by artificial intelligence module for calculations for evaluationand recommendation of the optimal exercise routine and effect of theroutine for a specific user.

In one embodiment, a cloud based software system or internet basedrobotic management system is used for data gathering, analysis andcontrol of the robotic limb rehabilitation apparatus. In one embodiment,the mobile frame is self-propelled by motors. The lower extremityexoskeleton device based sensor and sensor is based on mobile frame,rope tilt sensor, detects the patient motion, and a proprietary controlalgorithm actuates the mobile frame drive motors such that itintelligently follows the patient during rehabilitation exercise.

Other features will be apparent from the accompanying drawings and fromthe detailed description that follows.

BRIEF DESCRIPTION OF THE DRAWINGS

The other objects, features and advantages will occur to those skilledin the art from the following description of the preferred embodimentand the accompanying drawings in which:

FIG. 1 illustrates a schematic perspective view of a robotic limbrehabilitation apparatus for limb rehabilitation depicting arrangementof a Mobile-Frame, according to an embodiment of the present invention.

FIG. 2 illustrates a schematic front view of a robotic limbrehabilitation apparatus with a patient, according to an embodiment ofthe present invention.

FIG. 3 illustrates schematic right-side view of a robotic limbrehabilitation apparatus with a patient, depicting a harness lockingmechanism, according an embodiment of the present invention.

FIG. 4A illustrates schematic left side view of robotic limbrehabilitation apparatus depicting a harness worn by the patient toprevent fall, according an embodiment of the present invention.

FIG. 4B refers to harness that is to be worn by user.

FIG. 5A illustrates a schematic front view of the right vertical supportmember.

FIG. 5B illustrates a schematic side view of the right vertical supportmember.

FIG. 6 illustrates a schematic arrangement of the harness pulley system,according an embodiment of the present invention.

FIG. 7A illustrates a schematic arrangement of the Dynamic WeightUnloading Mechanism for expansion mode for FIG. 7B for more details,according an embodiment of the present invention.

FIG. 8 shows the entire robotic limb rehabilitation apparatus with usersecured with harness and lower extremity exoskeleton device.

FIG. 9 shows the entire robotic limb rehabilitation apparatus withoutuser to show a belt and lower extremity exoskeleton device.

FIG. 10 illustrates a schematic arrangement of the lower extremityexoskeleton device with waist clamp, according to one embodiment.

FIG. 11 illustrates a schematic arrangement of the lower extremityexoskeleton device with a height adjusting mechanism, according to oneembodiment.

FIG. 12 expands the waist clamp of FIG. 10 to show more details.

FIG. 13 shows an integrated robotic limb rehabilitation apparatus andsystem, in one embodiment.

FIG. 14 shows a processor on a hardware/device/mobile device variousmodules.

FIG. 15 shows a flow chart for the method of using the roboticmanagement system.

FIG. 16 shows a therapist graphical user interface on a mobile device.

FIG. 17 shows a detailed therapist graphical user interface for onepatient.

FIG. 18 shows starting of calibration for a patient in therapistinterface.

FIG. 19 shows Biofeedback for the exercise after calibration.

FIG. 20 shows the therapist using the protocols page for the patient.

FIG. 21 shows the patient being tested for walking on a carpet.

FIG. 22 shows the results of the patient walking on the carpet.

FIG. 23 shows subsequent steps for the patient on the rest of theprotocol.

FIG. 24 shows results of the up and go test used for patient.

FIG. 25 shows if there are alerts for patients during exercise.

FIG. 26 shows the results of the tests that have been performed.

FIG. 27 shows a therapist dash board showing all the protocols beingfinished and their scores.

FIG. 28 shows the therapist dash board showing an entire set of finishedresults.

Other features of the present embodiments will be apparent from theaccompanying drawings and from the detailed description that follows.

DETAILED DESCRIPTION

Robotic management system and method for using a robotic limbrehabilitation apparatus to control the robotic limb rehabilitationapparatus are disclosed. There is a need for evaluation and treatment ofpatients with short- or long-term physical and/or cognitive impairmentsand disabilities that result from musculoskeletal conditions (neck orback pain, or sports or work injuries), neurological conditions (stroke,brain injury or spinal cord injury) or medical other conditions. Thegoal is to decrease pain and enhance performance without surgery.Instant robotic limb rehabilitation apparatus and software system withfeedback mechanism helps user/patients with treatment methods such asregaining a proper gait. The present robotic management system enablesthe apparatus to be controlled by feedback mechanism, artificialintelligence built into the system to read the sensor input and progressof the patient and adjust the treatment to enable the user to improvesystematically. There are many rehabilitation areas that variousmodifications and changes may be made to these embodiments withoutdeparting from the broader spirit and scope of the various embodiments.

The present invention comprises a robotic management system to controlthe mobile-frame for robotic lower limb rehabilitation apparatus by thetherapists, users and doctors. Robotic management system is designed totreat several conditions and adjust the treatment levels for Gaitanalysis or debilitating diseases such as spinal cord injury, stroke,diabetes, neural diseases, injury, accidents, Stroke, Spinal CordInjury, Traumatic Brain Injury, Multiple Sclerosis, Osteoarthritis,Rheumatoid Arthritis, Limb Loss, and Back Pain etc., but not limited tothese. Gait analysis involves measurements that involve temporal/spatialconsisting of speed, the length of the rhythm, pitch etc., kinematics,markerless gait capture, pressure measurement, kinetics that involvestudy of forces in the production of movements and dynamicelectromyography. This use of kinetics, however, does not result ininformation for individual muscles but muscle groups, such as theextensor or flexors of the limb. To detect the activity and contributionof individual muscles to movement, it is necessary to investigate theelectrical activity of muscles. The sensors attached to the foot pad andknee joints braces and the machine sensors in this current applicationallows us to get feedback on not only for the gait analysis but also forthe effect of exercise on big muscles such as the extensor or flexors ofthe limb. The reading may not be limited to only these muscle groups butmay also include back and hip muscles etc.

A plurality of (embedded and non-embedded) sensors for smart assistance(help as needed by patient) and operation of the robotic lower limbrehabilitation apparatus. An object of the present invention is toprovide a novel design for a robotic limb rehabilitation apparatus andsoftware system. The robotic limb rehabilitation apparatus and softwaresystem is a combination of dynamic weight unloading system,mobile-frame, lower extremity exoskeleton device and harness to supportthe upper body to work in conjunction with common power, controls,optimized actuators and motors that are capable of enhancing recoveryprogress.

FIG. 1 illustrates a schematic perspective view of the robotic limbrehabilitation apparatus depicting arrangement of a mobile-frame and thedynamic weight unloading system, according to an embodiment of thepresent invention. The Mobile-Frame (100) comprises a right verticalsupport member (122) and a vertical support member (101) affixed on amoving platform. The right vertical support member (122) and the leftvertical support member (132) are connected to each other by ahorizontal cross bar (104). Further, the mobile-frame (100) alsocomprises a boom arm assembly (304) which is connected to the horizontalcross bar (104). The mobile-frame also include at least one therapistSeat (124 and 130) affixed on the moving platform to enable thetherapist to be seated comfortably while assisting the patient eitherfrom the right side or left side. According to an embodiment of thepresent invention, the mobile-frame (100) is manufactured using alightweight material such as aluminum or any composite materials or anysuch similar materials.

The first vertical support member (122) of the mobile-frame (100)includes Pulley 1 (120), Pulley 2 (102) and a Winch Assembly (108) asshown in FIGS. 1 and 6. The mobile-frame (100) also includes twoadditional Pulleys-Pulley 3 (606) in the cross bar (104) and Pulley 4(608) in the boom arm assembly (304), as shown in FIG. 6 wherein all thepulleys are connected via flexible rope arrangement.

The left vertical support member (132) of the mobile-frame (100) housesat least four servo drives (106) for electric motors, an electroniccontroller (112), at least one inverter (110), at least one batterycharger (114) and one or more batteries (212, 208, 210, 204, 206) (asshown in FIG. 2) to run the control function and also provide power tothe mobile-frame and exoskeleton.

The mobile-frame includes a pair of height adjustment arm support (116,118) attached to the right and left vertical support member (122, 101)as a support for the patient to hold on during the rehabilitation. Theheight of adjustment arm support (116,118) can be adjusted at least tofive levels.

The mobile-frame (100) is a movable frame and movability of the platformis aided by two sets of wheels-left and right caster wheel set (126 and128) (Front Wheel set) and left and right rear wheel set (314) (RearWheel set) (refer FIGS. 1, 3 and 4) attached to the wheel supportmembers. The front wheel set (126 and 128) is for steering themobile-frame (100) and while the rear wheel set (314), powered by amotor on each wheel, is for driving the mobile-frame (100) with thepatient/individual/user during rehabilitation. The movement of themobile-frame (100) is controlled by a remote-controlled device orcomputer device present with the therapist, doctor or patient.

FIG. 2 illustrates a schematic front view of the mobile-frame (100) witha patient in standing position, according to an embodiment of thepresent invention. The mobile-frame (100) provides support to a patient(202) who is in a standing position using a spreader bar (214), aharness (218) for weight support, and the pair of height adjustment armsupport (116,118) attached to the right and left side verticalstructural support members (122 and 101).

According to an embodiment of the present invention, a harness (218) forweight support, is provided to support/secure the torso and pelvicregion of an injured individual/patient/user (202), wherein the materialused for harness is made from a human skin friendly material or asimilar padded material.

FIG. 3 illustrates a schematic right-side view of the mobile-frame witha patient, depicting a harness locking mechanism, according to anembodiment of the present invention. The mobile-frame particularly showsat least a pair of spring (310) in the weight unloading mechanism, aflexible rope arrangement (308), a motorized rear wheel (314), a brakeresistor (312) along with the boom arm (304), the harness lockingmechanism (306), the therapist seat (130), the height adjustable armsupport (118) and the patient/individual/user (202).

According to an embodiment of the present invention, the flexible ropearrangement (308) is used as a means for operating the weight unloadingmechanism. The pair of springs (310) is provided to aid in the operationof the weight unloading mechanism. The brake resistor (312) is providedfor heat dissipation of regenerated power during fall arrest (314).

FIG. 4A and 4B illustrates a schematic left side view of theMobile-Frame depicting a harness (218) worn by the patient (202) toprevent fall, according to an embodiment of the present invention. TheMobile-Frame particularly shows the harness (218), wherein the harness(208) comprises of a pair of locations (410 in FIG. 4B) for locking theharness to the spreader bar (214), a torso securing strap (404) and apelvis securing straps (408), along with the boom arm assembly (132),the harness locking mechanism (306), the therapist seat (124), theheight adjustable arm support (116), the patient/individual/user (202)and the motorized rear wheel (314) with a motor (406).

According to an embodiment of the present invention, the harness (218)is connected to the spreader bar (214) with the help of harness lockingmechanism (306) at the two locations (410) which in turn connected tothe Boom arm (304) using a flexible rope (302). The torso securing strap(404) and the pelvis securing straps (408) are provided in the harnessto secure the patients torso region and pelvis region. The harnessdisclosed herein provides for an easy donning/doffing on thepatient/individual/user thereby reducing time and discomfort experiencedby the patient/individual/user.

According to an embodiment of the present invention, the motor (406)drives the rear wheel (314) of the mobile-frame enabling it to be movedaround while operating the mobile-frame by the therapist.

FIG. 5A and 5B illustrates a schematic side view and front view (520) ofthe right vertical support member (102) of the mobile-frame (100),according to an embodiment of the present invention. The right verticalsupport member (102) of the mobile-frame (100) comprises of acylindrical load cell (502), a motor (504) to control ball screw, amotor (506) to control a winch drum, a coupling (510) arrangement, apair of springs (512), a pair of ultrasonic sensors (514, 508) and astring potentiometer (516).

According to an embodiment of the present invention, the cylindricalload cell (502) is provided to measure the tension on the flexible rope(308) member passing over it. A pair of motors (504 and 506) is providedto control the ball screw and the winch drum. Further the motors (504and 506) are connected to the arrangement below an upper support plate(712) with the help of the coupling (510). The pair of ultrasonic sensor(514 and 508) is provided therein, one at the upper support plate (712)and other at a lower support plate (714) to sense the movement of thecarriage. Additionally, a string potentiometer (516) is provided todetect and measure the linear position. In addition a linear encoder(518) is used in the design for detecting the rope movement speed toarrest fall.

FIG. 6 illustrates a schematic arrangement of rope assembly (600) of thedynamic weight unloading mechanism, according to an embodiment of thepresent invention. The rope assembly (600) of the dynamic weightunloading mechanism comprises of a pulley 1 (612) on sliding carriage ofthe dynamic weight of unloading mechanism, a pulley 2 (604) in the rightvertical structural support member (122), a pulley 3 (606) housed in thehorizontal cross bar (104), a pulley 4 (608) housed in the boom armassembly (304), a flexible rope (602), a spreader bar (214) and a winchassembly (610 or 108).

According to an embodiment of the present invention, the flexible rope(602) arrangement runs over the series of four pulleys (612, 604,606,608). The rope assembly (600) arrangement involves attaching theflexible rope at one end to the motorized winch assembly (610) passesthrough the pulley housed in the boom arm (304) and connected to theSpreader Bar (214) at the other end.

A portion of FIG. 7A is expended as FIG. 7B to show more details. FIG.7A and 7B illustrates a schematic arrangement of the dynamic weightunloading mechanism (702). The dynamic weight unloading mechanism (702)comprises of a ball screw (708), a motor (704) to control the ball screw(708), a ball nut (710), a coupling (706), a pulley (612), an ultrasonicsensor (514), a guide rails (720), an end support (716) at upper andlower support plate, an upper spring support plate (712) with the ballnut (710), and a lower spring support plate (714) with pulley (612).

The servo motor (704) is coupled to the upper support plate (722) withthe help of coupling (706). The two guide rails (720) along with onecentrally located ball screw (708) is connected with the upper supportplate (722) and lower support plate (716) through the springarrangement. The carriage is enabled to slide on two guide rails (720)with two spring supported plate (512). The movement of the carriageupward and downward is controlled by the rotation of the ball nut (710)on ball screw (708). The ball nut (710) is connected to the upper springsupport plate (712) and the ball screw (708) passes through the same.The pulley (612) is attached to the lower spring support plate (714)through the rope (302) from the winch (610) is passed. The movement ofthe support plates both at the upper and lower is detected using the twoultrasonic sensors (514, 508) provided thereunder. A means for measuringthe movement of the carriage is provided with the help of linearencoder.

FIG. 8 illustrates a schematic arrangement of the lower extremityexoskeleton device and patient secured with the harness, according to anembodiment of the present invention. The apparatus comprises of themobile-frame (100), a weight support harness (218), and a powered lowerextremity exoskeleton device (810), wherein the patient/user (204) issecured by the lower extremity exoskeleton device (810).

In the lower extremity exoskeleton device, the first set of motorizedjoint (804/1004) connects with the waist clamp to the upper shank aroundthe hip area of the patient/user (204). The second set of motorizedjoint (806/1008) connects with the upper shank to the lower shank aroundthe knee area of the patient/user (204).

FIG. 9 shows a schematic diagram of the lower extremity exoskeletondevice with a waist clamp ensemble. A connecting port (904) ensuressupply of power and signals from the batteries and computers housed inmobile frame (100) to the motors and sensors via tethered cable (902).The adjustable height support 906 allows accommodating for heightadjustment for patients of different heights.

FIG. 10 shows details of the lower extremity exoskeleton device lowerextremity exoskeleton device comprises of a waist clamp mechanism(1002), a pair of motorized hip joints (1004), a right upper shank clamp(1020), a left upper shank clamp (1020), a pair of motorized knee joints(1008), a right lower shank clamp (1016), a left lower shank clamp(1010), an unpowered ankle joint (1012) and a foot pad (1014). The footrests show sensors 1024.

The lower extremity exoskeleton device comprises of a pair of motors(1004 and 1008) wherein the motor (1004) controls the hip joints and themotor (1008) controls the knee joint. The third joint connecting theshank clamps (1018 and 1008) to the foot pad (1014) is not motorized andarranged to adjust as per the user's position.

FIG. 11 illustrates a schematic arrangement of a height adjustingmechanism, in the lower extremity exoskeleton device. The heightadjusting mechanism is provided which includes height adjustable slots(1106 and 1104) between the motorized knee joint and the lower shank atthe right side and the left side.

The motorized knee joint (1008) helps in the movement of legs ascontrolled by the therapist. Further, based on the height of thepatient/user, the height of the lower shanks can be adjusted with thehelp of the multiple adjustable slots (1020/1106) provided to adjust theheight both at the right side lower shank and the left side lower shank.

FIG. 12 illustrates a schematic arrangement of the waist clamp (1002) indetail, according to an embodiment of the present invention. The waistclamp (1002) comprises of a waist support (1206), an adjustable lengthstrap (1208) with padding, and a strap locking mechanism (1202).Additionally, the shank clamps (1204) are provided with apadding/cushion, and a height adjustment release button.

In one scenario, the user/patient fails to control voluntary movementmay be due to damage to a portion of the brain or spinal cord forexample in the case of Spasticity, car crash, or other symptoms. Inorder to overcome such situation, the robotic lower limb rehabilitationapparatus and system is adapted with a smart control unit whichcomprises a plurality of sensors and a controlling module. The pluralityof sensors detects the unusual movements/actions of the patient andprovides a signal to the controlling module. The controlling moduleprocess the signals and converts the operation into a transparent modeon identifying the unusual movement or predefined conditions, in orderto avoid any harm to the patient or robotic lower limb rehabilitationapparatus.

FIG. 13 shows a system view of the robotic lower limb rehabilitationapparatus 1312 and connectivity with software. Internet 1304 connectsall elements of the software to the hardware the robotic lower limbrehabilitation apparatus 1312. Session scheduling and reporting module1302 controls the robotic lower limb rehabilitation apparatus and thesensors, loads and the motors to help the patient to optimize theexercise routine. Artificial intelligence module 1314 accommodates andcalculates optimal exercise routine for the said user and also sendsfeedback to doctor, therapist and patient regarding new exerciseschedule and improvements. Sensors that are embedded in the roboticlower limb rehabilitation apparatus allow the artificial intelligencemodule 1314 to gather information while the user is using it and basedon prior exercises. User interface module 1310 allows user to see whatthe doctor and the therapist have designed for that particular day forthem to follow. Also it gives them a comprehensive view of the therapyregiment. Database 1308 enables all stake holders to store and retrievedata in real time as well as historical data. All modules use input fromthe database 1308 and store information for future use. Device 1306 maybe used by therapist or doctor or patient for input and viewing. Thefollowing figures when described will cover these elements in detail.Devices may be mobile device or computers.

FIG. 14 show that robotic management module 1400 is embedded in aprocessor 1410. It has many modules such as management module 1402, datamodule 1404, doctors module 1406, patient module 1408, exercise module1311, therapist module 1412, cloud support module 1412, assessmentmodule 1316 and device module 1418. This robotic management module 1400is not just limited to these modules. More modules can be updated,uploaded and modified according to the need. Management module 1402enables to do the patient evaluation 1502 if FIG. 15 to start a therapysession. The software is driven by the management module (1402) whichsetups the backend information about the hospitals/clinics, the users(doctors, therapists) and the patients. Based on the condition of thepatient, the doctor can choose to enroll the patient for roboticrehabilitation. Using the doctor module (1406), the doctor now sets up arehabilitation plan for the patient and uses one of the manyrehabilitation measures using which they will measure the patient'sprogress. (The rehabilitation measure is a way of determining the stateof the patient in a numerical assessment. As an example of the measurecould be the SCI-FAP score which uses a set of 7 exercises and gradesthe patient on a scale of 2100 where lower the score, the better thepatient is).

Once the doctor sets up the rehabilitation plan, the patient can nowschedule sessions (1302) for the robotic rehabilitation with thetherapist. The therapist now uses the Therapist module (1412) to definehow many session and what exercises they would want to do in eachsession. They also define a session goal so that they can monitor theprogress. The therapist has a bank of pre-defined exercises (1311) thatthey can use to plan the sessions for their patient. They can alsocreate and add custom exercises if they want.

When the patient shows up for a session, the management module (1402)registers the same and this shows up in the therapist UI (1602). Thetherapist gets to know each of their patient and their conditions alongwith the assessment plan for them (1704). They calibrate the device(1802) to check that the device is functioning fine. Then they strap onthe patient onto the device and run them through a BioFeedback (1910).This verifies that the device has been adjusted (1906) for the specificpatient (adjusted to their height, hip-knee, knee-ankle lengths etc.).This also checks how the patient is feeling on this specific day (1908)(are they tired, do they have pain and so cannot stretch more todayetc.). An object of the present invention is to provide a dynamic weightunloading mechanism wherein the therapist can control the amount ofweight support to the patient/individual/user while being assisted bythe exoskeleton. As a result, the patient/individual/user is exposed tocontrolled change in the body-weight balance which in turn promotes orteaches the patient/individual/user to self-balance.

The therapist now selects the protocols/exercises that they wish toadminister to the patient (2002). This is based on the doctor'srecommendations (1504) and the exercises that the therapist has setup.Going forward these recommendations will also be provided by the AImodule which (1314) which uses machine learning algorithms to determinethe best exercise for the patient's rehabilitation.

For any specific exercise the therapist can control the thresholds forthe exercise (2102). For example: they can set the gait speed to aspecific value. They can choose to reduce the stride length on aspecific day as the patient might be complaining of pain when theystretch. However, the therapist could also choose the increase thesethresholds—like leg lift if they feel that they pain/effort will benefitthe patient's rehabilitation. According to an embodiment of the presentinvention, a transparent no resistance actuator control mode is utilizedto address spasticity/movement i.e., in persons with locomotiondisability covering therapeutic rehabilitation. According to anembodiment of the present invention, a system is provided for specificrehabilitative movements using reward/penalty mechanisms using VirtualReality games specific to certain conditions such as Spinal Cord Injury(SCI), Stroke, etc.

According to an embodiment of the present invention, a smart system isprovided to sense intent to turn (other than dual supports for bodyweight support). Depending on the patient's disease and patient exercise(1508) requirements, the Mobile-frame provides holistic gait trainingfor the patient with better results, both in terms of faster attainmentof outcomes as well as higher locomotive capabilities.

The robotic lower limb rehabilitation apparatus that combines themechanism of both dynamic weight unloading system, mobile-frame andlower extremity exoskeleton device in conjunction with common power,controls and optimized actuators and motors using the machine sensorinputs 1510.

The user interaction force sensors sense if there are any abnormalitiesand in case if any abnormality is found then the system goes intotransparent control mode on the lower extremity exoskeleton device andreducing the lower extremity exoskeleton device to ZERO resistance, andsimultaneously the dynamic weight unloading mechanism goes into SAFEmode holding up the user's full weight. This allows the user's legs toshake freely without experiencing any high forces, and prevents falling.Further, this prevents the actuation motors from high torques andburnouts. The assessment module 1512 continuously not only records theexercise routine but also helps therapist plan 1506 and the machinesensor inputs to be corrected after the data is collected using thisassessment module. Once the satisfactory results are achieved thetreatment is finished for the day 1514.

The robotic lower limb rehabilitation system is provided to introduceintentional and controlled perturbations as a part of therehabilitation. The combination of the dynamic weight unloadingmechanism and lower extremity exoskeleton device allows suchperturbation forces to be initiated without any safety concerns,enabling better and faster rehabilitation therapy. Furthermore, aVirtual Reality system is provided for immersing the user into areal-world situation, and by sensing the user's gait/forces appropriateactuation can be initiated for best therapy results. Also, the roboticlower limb rehabilitation has a sensing module which includes but notlimited to one or more sensors, is capable to sense the user's intent tomove forward, stop and turn.

In one scenario, the user is unable to perform any activity within apredefined limit such as walking or holding something as part oftherapeutic rehabilitation. In such scenario, a control unit inbuilt inthe robotic lower limb rehabilitation apparatus gets activated andprovides necessary assistance in control manner to enable patient/userto perform such activity as assigned. The assistance in control manneris provided in such a way that the user is able to overcome suchweakness slowly.

In one embodiment, the robotic lower limb rehabilitation apparatus isadapted to use specific rehabilitative movements using reward/penaltymechanisms such as in games. This is a non-traditional way to train andrehabilitate the patient. According to the embodiment, the robotic lowerlimb rehabilitation apparatus and system may include a virtual realitysystem (VR system) for providing training/therapy to the user/patient inwhich the system determines the level or capability of the user andassigns a task. The level of task is in such a way that the user canable to execute the same and also improves his/her motor ability. Theuser is awarded upon successfully completion of said task. Award systemmotivates the user to repeat the same again and again and simultaneouslyimproves on his physical weakness. In case the user is unable tocomplete said task, the user is penalized. This award and penaltymechanism motivates the user to take additional effort to execute saidtask which in turn help him in overcoming the disability. Additionally,the VR system enables user/patient to train and execute the taskcorrectly in the absence of therapist proper attention or caliber.

The robotic lower limb rehabilitation apparatus is operated/controlledusing software that is principally of 4 types: Therapist UI from wherethe commands are given and progress is monitored, Controls software thathas the configurations/settings for various parameters (torque, poweretc.) for a certain disease state (e.g. SCI) and a specificpatient—these would be robotic rehab protocols that are converted tosoftware form, Application to record sensor data comprehensively andaccurately and generate reports and artificial intelligence (AI)software to detect patterns in the data collected and thereby enablerecovery predictions as well as efficacy of protocols.

The method of using the robotic lower limb rehabilitation apparatus isdone as follows: the patient is brought to the mobile-frame in awheelchair by a member of the hospital staff. The physiotherapist putsharness jacket on patient and clasps the hooks from BWS on jacket whilethe patient sits in the wheelchair. Donning/Doffing of the harness canbe easily secured through straps made from human skin friendly materialand locking mechanism. The physiotherapist presses button, whichactivates the dynamic body weight system (DBWS). The DBWS enables apowered winch to lift the patient to a semi-standing pose (with theappropriate unweighing). Unweighing means part of the patient is borneby the system thereby helping fragile patients.

Initially, a percentage of unweighing is set for a patient. However, dueto the motion of the patient during setup, fluctuations in load aresensed by the system. The cylindrical load cell detects the resultanttension, which in turn is sent to the electronic controller. Usingproprietary feedback control algorithm, instantaneous actuation signalsare sent to the motors so that the patient feels a constant load relief.The physiotherapist then straps the lower extremity exoskeleton deviceonto the patient (easier to do since wheelchair does not hinder—there is360 degrees access all around patient).

The lower extremity exoskeleton device can be easily mounted on to thepatient with the help of adjustable skin friendly material clamps. Theadjustable clamps would ensure that the lower extremity exoskeletondevice addresses patients of varied populations, sizes and body shapes.This would also ensure that the less man power is required whilestrapping the Exo on the patient. The battery and the computer are noton the lower extremity exoskeleton device (they are on the DBWS) whichmakes the lower extremity exoskeleton device much lighter. The lowerextremity exoskeleton device and the DBWS are connected through aconnecting port with a tethered cable. This ensures supply of power andsignals from the batteries and computers housed in the mobile frame tovarious motors and sensors on the lower extremity exoskeleton device. Asthe power source is away from the lower extremity exoskeleton device,the battery technology need not be complicated.

The physiotherapist presses the full stand mode which lifts the patientto a full stand mode. The person is now upright and hands free (Nocrutches are needed). The side arm bars are for the patient to feelsecure but are not needed for locomotion. The patient starts walkingslowly on the floor and the robotic lower limb rehabilitation apparatusfollows. Locomotion on the floor is aided by two sets of wheels, one forsteering and the other for driving the mobile-frame. In addition,multiple sensors like the rotary potentiometer are provided on the DBWSfor sensing patient's intent to move or stop. The side arm bars are forthe patient to feel secure but are not needed for weight bearingsupport. The side arm bars are provided with sensors which aid inproviding turning inputs to the DBWS. The patient will not fall duringthe walk (in spite of there being no human support) owing to theharness. In case he loses balance, the patient will be “caught” by theharness with minimal jerk. When a patient fails to control voluntarymovement, a smart control unit with multiple sensors detects the unusualmovements and provides a signal to the controlling module. Thecontrolling module processes the signals via proprietary algorithm andinstantaneously transfers the system into appropriate transparent modeor fail safe mode in order to avoid any harm to the patient orMobile-frame apparatus. Being an internet of things (TOT) device,locomotion parameters of the patient are captured automatically andstored. The robotic lower limb rehabilitation apparatus is portablewithin the hospital and can be wheeled easily to another room using theadjustable boom.

The robotic lower limb rehabilitation apparatus is suitable for moreserious injuries and neuro-rehabilitation i.e. patient needs the lowerextremity exoskeleton device to propel him/her forward and initiatewalking while the harness helps to avoid fall. Note that the DBWS alone(excluding the lower extremity exoskeleton device) can be used forlesser injuries/advanced recovery i.e. patient has strength in legs tomove forward but needs to learn balance and strengthen leg muscles forindependent locomotion.

Rehabilitation is a customized process using artificial intelligencemodule for each patient—and also for each specific day. The softwareanalyzes the entire background of the patient, the bio-feedback on aspecific day and also the overall recommendation based on machinelearning algorithm. It then uses this to drive the hardware: for exampledetermining the power assist required at the left hip. Using thesensors, it can assess if the patient is putting more weight on one footand if that has an impact on the muscle in that leg. Using thisinformation, it can vary the power-assist allowing the patient to movethat specific leg more easily.

Once the session is started, the system collects data from the variouson-board sensors (2206, 1510) and also maps it onto the patient activity(2202). The detailed activities (2204) are logged and are also analyzedin real time for alerts (2504). This data that is collected is analyzedin the data module (1404) and stored in the database (1308). Theseassessment results (1512) are converted into reports which are availableto all concerned parties including the patient, doctors, therapists andthe insurance personnel.

All the data is stored in the cloud support module (1412) which is usedfor the AI learning (1314). This bank of data is what makes the systemsmart and allows the robotic device to be personalized and customizedfor each patient for each rehabilitation session.

FIG. 16 shows a graphical user interface for a therapist that haswaiting patient list 1602, four patients 1604, 1606, 1608 and 1620showing different season status. FIG. 17 shows for a patient 1702 thestatus, notes 1708 and spinal cord injury functional ambulation profilescore (SCI-FAP score) after the start of the robotic rehab 1706. Theuser interface further shows many tabs in FIG. 18, FIG. 19 and FIG. 20to show calibrate, bio feedback, protocols and feedback 1802 and itemssuch as air walk 1804 data. FIG. 19 shows biofeed back 1910 for apatient 1904 and verify adjustments 1906 and administer test 1908. FIG.20 offers Sci-fap protocols 2002.

FIG. 21 shows adjusted parameters 2102. FIG. 22 shows gait 2202 oncarpet, session completion 2204, and a pause button 2208. FIG. 23 showsoverall score for the patient 2302. FIG. 24 further elaborates onadjusted scores 2406 and another exercise 2402 say up and go. Thevariable assistance is recorded as well at 2404. FIG. 25 shows howinteractive this Mobile-frame apparatus is by recording spasticity alert2504 for a gait 2502 and a therapist or patient can hit a pause button2506. FIG. 286 shows various scores 2602 for the given patient. FIG. 27sums up all other exercise assessment scores 2702 for a given SCI-Fapprotocol for a specific patient. The doctor, therapist and patient canfurther review 2806 and see the scores 2804 and comments 2802 in FIG.28.

Although the embodiments herein are described with various specificembodiments, it will be obvious for a person skilled in the art topractice the invention with modifications. However, all suchmodifications are deemed to be within the scope of the claims. It isalso to be understood that the following claims are intended to coverall of the generic and specific features of the embodiments describedherein and all the statements of the scope of the embodiments which as amatter of language might be said to fall there between.

What is claimed is:
 1. A robotic management system processed using a processor, comprising: a robotic limb rehabilitation apparatus having a mobile-frame and a lower extremity exoskeleton device with multiple sensors for communicating an exercise parameter and its affect to a doctor, a therapist and a patient in real time; a mobile device and a database connected by an internet, controlled by a robotic management module, session scheduling and reporting module and an artificial intelligence module for a limb rehabilitation for the user.
 2. The system of claim 1, wherein the robotic management module comprises of: a management module combines the mechanism of both dynamic weight unloading system, mobile-frame and lower extremity exoskeleton device in conjunction with common power, controls and optimized actuators and motors using the machine sensor inputs to optimize the use of the robotic limb rehabilitation apparatus; a data module collects a data various on-board sensors and maps it onto the patient activity, detailed of the activity, analyze the data in real time for alerts, store the data in the database and convert the data into reports which are made available to the patient, doctors, therapists and an insurance personnel; a doctors module enables the doctor to set up a rehabilitation plan for the patient using the rehabilitation measure and loading the exercise plan onto the patient module and therapist module; a patient module contains patient profile and allows the patient to pick the time, therapist and doctors for their treatment; an exercise module is used for storing a programmed exercise list, artificial intelligence based recommended exercise list and doctor recommended exercise list; a therapist module is used by the therapist to define how many sessions and what exercises the therapist would want to do in each session by the patient recommended by the doctor specific to the patient; cloud support module used for the artificial intelligence learning and allows the robotic limb rehabilitation apparatus to be personalized and customized for each patient for each rehabilitation session; assessment module continuously not only records the exercise routine but also helps therapist plan and modify the machine sensor inputs after the data is collected; and a device module to operate the robotic limb rehabilitation apparatus to manage a gait correction after a debilitating illness.
 3. The system of claim 2, further comprising; an artificial intelligence module analyzes the entire background of the patient, the bio-feedback on a specific day and also the overall recommendation based on machine learning algorithm, designs a restorative workout session based on the sensor feedback from the users previous exercise routines. 